1. Field of the Invention
The invention relates to an electrosurgical instrument for the therapy of varices, in particular of small varicose dilatations of the cutaneous veins.
2. The Prior Art
Varices are understood to be veins extending along the surface of the body, which, in most cases, are pathologically dilatated lig bags or in the form of knots. Due to occupations requiring standing, overweight, tight garments or pregnancy, small varicose dilatations of the cutaneous veins of the legs develop particularly frequently from an innate weakness of the connective tissue. In view of the civilizationally conditioned increase in said promoting factors, more and more people suffer from the consequences of the primary varicosis caused thereby. In the advanced stage, varices are sometimes very painful and not infrequently lead to work disability. Therefore, the earliest possible therapeutic treatment of small varicose dilatations of the cutaneous veins and small varices is indicated.
According to the state of the art, the so-called sclerosing is commonly applied for the treatment of small varicose dilatations of the cutaneous veins. In this connection, following a prior injection of air, an obliterating agent is injected in the affected section of the veins. This is followed by a compression treatment, for example in the form of compression bandages or compression hoses.
The aforementioned method has the advantage that especially in the treatment of small varicose dilatations of the cutaneous veins, no surgical intervention is required. Otherwise, however, known obliterating methods lead to unsatisfactory results: Medicinal sclerosing often leads to more or less extensive spotted discolorations of the skin, which is not only perceived as annoying cosmetically, but also represents a psychic stress for the patient. Furthermore, the therapy is relatively protracted because several successive treatments are required at intervals of several days. Moreover, with sclerosing, the rate of recidivism is relatively high.
Furthermore, attempts have been made to therapeutically treat small varicose dilatations of the cutaneous veins by irradiation with laser light. These methods, however, have been insufficient heretofore, and permitted only minor cosmetic corrections. The laser therapy, according to the current state of knowledge, seems to hold only little promise for success for a comprehensive treatment of small varicose dilatations of the cutaneous veins and varices.
A method of treating varices is known from U.S. Pat. No. 3,301,258, which is based on the destruction of, the diseased section of the vein by means of electrical current (diathermy current). The instrument for carrying out the method, which is disclosed in the US-document as well, has two electrodes, which are electrically insulated against each other and arranged at the distal end of a small cylindrical probe, as well as means for generating and transmitting electrical current to said electrodes.
For treating the varix, the probe is inserted in the skin of the patient through a cut and subcutaneously guided on until the electrodes, for which provision is made at the distal end of the probe, have reached the site to be treated. Subsequently, an electrical current is permitted to flow through the electrodes; the heat generated in this connection leads to the destruction of the neighboring vein section. However, the surgical instrument for the treatment of varices according to the aforementioned US-patent is not suitable for ambulatory therapy because the surgical intervention connected therewith requires a hospital stay and leads to considerable stress for the patient.
A surgical instrument for us in diathermyand similar medical and surgical treatment is known from U.S. Pat. No. 1,943,543, said instrument consisting of a grip, an insulating sleeve, and two electrodes mounted on the grip. The two electrodes are surrounded by the insulating sleeve, and can be left free by displacing the sleeve. When the electrodes are inserted in the tissue to be treated, the insulating sleeve remains on the surface of the tissue, so that the electrode section projecting into the tissue remains uninsulated. The above surgical instrument is not suitable for the treatment of varices because due to the lack of insulation of the electrodes, current can flow along the surface of the skin, which leads to the formation of cosmetically disfiguring current marks.
From this results the problem of the invention, which is to provide the treating therapist with a surgical instrument permitting a therapy of varices with small varicose dilatations of cutaneous veins and the like, which can be carried out quickly and safely with as little stress as possible for the patient and with minimized side effects. In addition, the objective is to keep the rate of recidivism as low as possible.
For solving said problem, the invention proposes on the basis of the surgical instrument for the treatment of varices according to U.S. Pat. No. 3,301,258 that the instrument has two fork-like arranged, protruding needle electrodes, which are connectable to different poles of an electrical current source, and which each are partly enclosed by a thin electrical insulation layer, which leaves the forward tip zone of the needle electrodes free, whereby the transition from the tip zone to the insulated zone is substantially stepless.